Saint Luke's Health System understands medical information is personal and we are committed to protecting it. Please print both of the attached documents and follow the instructions provided.

Please note our NEW address of 4200 Broadway Kansas City, MO 64111. This location processes Saint Luke's Hospital, Saint Luke's Cancer Institute, Saint Luke's East - Lee's Summit, Saint Luke's Northland Hospital, Saint Luke's South, and Cushing Memorial Hospital.

• Instructions for Authorization Form
• Information Request - Patient Authorization
• After you have completed the authorization form, you may mail to the address listed in the instructions; or you may scan/ e-mail the form to roi@saint-lukes.org and your request will be mailed or ready for pick up at the 4200 Broadway location.